"The days when hospital boards behaved like fraternities are over," declares Presbyterian Healthcare CEO Jim Hinton in the July issue of Hospitals & Health Networks. "Governance needs to change, to not be a social club, but a social conscience."

That's a pretty profound notion, and a timely one. American health care is in the midst of a dramatic transformation, and today's hospital trustees must possess the skills and vision — not to mention the intestinal fortitude — to meet a variety of fundamental challenges head on. One of the most fundamental: How will this organization fit into the new world order?

The Hinton quote comes in the latest installment of H&HN's year-long Generations in the Workplace series. Since January, our bimonthly series has considered the fact that, for the first time ever, the American workforce includes four distinct generations, from the so-called veterans born before 1946 to baby boomers, Generation Xers and Millennials. Each tends to have somewhat different life and career goals, work habits and world views. Intergenerational tensions are inevitable; hospitals should understand how to mitigate those and how to recruit and retain the best staff possible.

The July article focuses on hospital boards, and the difficulty of finding younger trustees to diversify a governance system that is now dominated by baby boomers. Younger members can bring a new dynamic to boards, with fresh ideas, fresh ways of weighing issues and a willingness to challenge how things are done.

Importantly, bringing in new blood now can help hospitals maintain board continuity as baby boomers bow out en masse in the not-so-distant future.

But joining a hospital board doesn't naturally occur to young professionals who have had few serious health issues. Hospital leaders must make concerted efforts to identify likely candidates and convince them to join. In her article, writer Laura Putre examines strategies some have used, such as asking candidates to participate in a governance project before they decide whether to formally jump in.

Hospitals have found that attracting and retaining younger trustees requires boards to rethink how they approach their work, with sometimes significant organizational and process changes. Gen Xers and Millennials will balk at too many meetings, too much talk and too much paper. With perhaps a bit of the arrogance and impatience young professionals have exhibited throughout the ages, they need to feel they're not spinning their wheels and that what they're doing will have a tangible impact.

As another person quoted in the article says, hospital boards in the past have sometimes had a "country club or retirement attitude." If so, it's an attitude that needs to go.